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BACKGROUND AND AIM: Refractive errors, amblyopia, strabismus, and low vision are more common among children with hearing impairments in comparison with their hearing peers. Neglecting visual disorders can pose educational and social problems for these children. The present study aimed to assess the prevalence of refractive errors, amblyopia, strabismus, and low vision among hearing-impaired and deaf students in Kermanshah. MATERIALS AND METHODS: A total of 79 deaf and hearing impaired students within the age range of 7-20 years (mean age of 15.01 ± 2.72) underwent optometric examinations, including autorefractometry, retinoscopy, ophthalmoscopy, slit lamp, visual acuity measurement, and cover-uncover test. Those who needed further evaluation were referred to the Ophthalmology Clinic of Imam Khomeini Hospital. RESULTS: Regarding the prevalence of refractive errors, 32 (40.5%) subjects had one or a combination of refractive errors, the most common of which was astigmatism (36.7%), followed by amblyopia (15.1%). The most common type of strabismus was latent strabismus (heterophoria) (88.6%), followed by exophoria (81%). Moreover, 3 (3.7%) cases had nystagmus. A significant difference was observed between the prevalence of amblyopia and the degree of hearing loss (P = 0.026), and no significant difference was detected in other cases. CONCLUSION: As evidenced by the obtained results, refractive errors, amblyopia, strabismus, and low vision are more prevalent among deaf and hearing-impaired children compared to normal children because deaf and hearing-impaired children are not able to convey their vision problems and need to compensate for their poor hearing with an enhanced sense of sight, inattention to these disorders can present these children with serious educational and social problems. Therefore, eye screening examinations are of paramount importance in deaf and hearing-impaired children.
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Ambliopía , Errores de Refracción , Estrabismo , Baja Visión , Agudeza Visual , Humanos , Estrabismo/epidemiología , Estrabismo/fisiopatología , Niño , Adolescente , Masculino , Femenino , Errores de Refracción/epidemiología , Errores de Refracción/fisiopatología , Errores de Refracción/complicaciones , Baja Visión/epidemiología , Ambliopía/epidemiología , Ambliopía/fisiopatología , Ambliopía/diagnóstico , Prevalencia , Adulto Joven , Agudeza Visual/fisiología , Irán/epidemiología , Estudios Transversales , Personas con Deficiencia Auditiva , Sordera/epidemiología , EstudiantesRESUMEN
Background: Asia accounts for more than half of the world's population and carries a substantial proportion of the global burden of blindness and vision impairment. Characterising this burden, as well as its causes and determinants, could help with devising targeted interventions for reducing the occurrence of blindness and visual impairment. Methods: Using the Global Burden of Disease Study 2019 database, we retrieved data on the number of disability-adjusted life years (DALYs); crude and age-standardised rates; and the prevalence (with 95% uncertainty intervals (95%UIs)) of blindness and vision loss due to six causes (age-related macular degeneration, cataracts, glaucoma, near-vision impairment, refractive error, and other vision loss) for Asian countries for the period between 1990 and 2019. We defined DALYs as the sum of the years lost due to disability and years of life lost, and calculated age-standardised figures for the number of DALYs and prevalence by adjusting for population size and age structure. We then evaluated the time trend of the disease burden and conducted subgroup analyses by gender, age, geographic locations, and socio-demographic index (SDI). Results: In 2019, the DALYs and prevalence of blindness and vision loss had risen by 90.1% and 116% compared with 1990, reaching 15.84 million DALYs (95% UI = 15.83, 15.85) and 506.71 million cases (95% UI = 506.68, 506.74). Meanwhile, the age-standardised rate of DALYs decreased from 1990 to 2019. Cataracts, refractive error, and near vision impairment were the three most common causes. South Asia had the heaviest regional disease burden (age-standardised rate of DALYs = 517 per 100 000 population; 95% UI = 512, 521). Moreover, the burden due to cataracts ranked high in most Asian populations. Being a woman; being older; and having a lower national SDI were factors associated with a greater vision loss burden. Conclusions: The burden due to vision loss remains high in Asian populations. Cataracts, refractive error, and near vision loss were the primary causes of blindness and vision loss. Greater investment in ocular disease prevention and care by countries with lower socioeconomic status is needed, as well as specific strategies targeting cataract management, women and the elderly.
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Ceguera , Años de Vida Ajustados por Discapacidad , Carga Global de Enfermedades , Humanos , Ceguera/epidemiología , Ceguera/etiología , Femenino , Masculino , Anciano , Persona de Mediana Edad , Asia/epidemiología , Adulto , Anciano de 80 o más Años , Prevalencia , Adulto Joven , Adolescente , Niño , Preescolar , Lactante , Catarata/epidemiología , Catarata/complicaciones , Baja Visión/epidemiología , Errores de Refracción/epidemiología , Errores de Refracción/complicacionesRESUMEN
PURPOSE: To investigate the between-eye differences of the crystalline lens in subjects with unilateral high myopia and assess its contribution to the interocular refractive error disparity. METHODS: Children and adolescents with unilateral high myopia, defined as cycloplegic spherical equivalent (SE) ≤ -5D in one eye and ≥ -3D in the other eye, were recruited. Ocular biometric parameters, including axial length (AL) and lens thickness (LT), were measured by IOLMaster 700. Other lens-related parameters, including anterior lens radius of curvature (ALR) and posterior lens radius of curvature (PLR), were measured by CASIA2 swept-source optical coherence tomography. Lens power (LP) was calculated using Bennett's formula. Paired t-test was used to assess the between-eye difference in biometric parameters, and multiple regression analysis was used to assess factors associated with the between-eye SE difference. RESULTS: Ninety-one participants (6-18 years of age; 52.75% girls) were included. The highly myopic eyes showed significantly lower LP (P < 0.001) and smaller ALR (P < 0.001) than the contralateral eyes, while no significant difference was found in central LT. In both eyes, ALR was significantly related to SE (P = 0.001 and P = 0.006, respectively); while LT was not associated with SE (P = 0.051 and P = 0.052, respectively). Paired-eye analysis showed that the between-eye difference in ALR was the only lenticular parameter significantly associated with the between-eye difference in SE (P = 0.005). CONCLUSION: In highly myopic eyes, the crystalline lens reduced total power but morphologically changed to a more curved shape without significant lens thinning, suggesting that the LP loss is mainly achieved by reducing its internal power in high myopes.
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Cristalino , Miopía , Errores de Refracción , Niño , Femenino , Humanos , Adolescente , Masculino , Ojo , Miopía/complicaciones , Refracción Ocular , Errores de Refracción/complicaciones , Longitud Axial del OjoRESUMEN
OBJECTIVE: The aim of this study was to determine the prevalence, causes of ocular disorders and visual impairment among preterm children previously admitted to neonatal intensive care units in Addis Ababa, Ethiopia. METHODS AND ANALYSIS: A prospective screening survey was conducted from February to June 2019 at the paediatric eye clinic of Menelik II Hospital. Children who were preterm at birth and who attended the eye clinic were included in the study. Data on demographic and neonatal characteristics, neonatal and maternal comorbidities and ocular disorders were collected. OR and univariate analysis were used to identify predictors of ocular diseases and visual impairment. RESULTS: There were 222 children included in the study with a mean age at presentation of 2.62 years (range 2.08-6.38 years), mean gestational age 34.11 weeks (range 30-36) weeks and mean birth weight 1941.72 g (range 953-3500 g). Nearly two-thirds had ocular disorders with refractive error (51.8%), strabismus (11.3%) and a history of retinopathy of prematurity (ROP) (7.2%) being more common. One-fourth of the children had visual impairment, and the prevalence of amblyopia was 40.1%. Uncorrected refractive errors, strabismus and ROP were causes for visual impairment. CONCLUSION: Visual impairment and amblyopia are common in Ethiopia. There is a need to develop a screening protocol for ocular disorders for preterm children to enhance early detection and prevention of childhood visual impairment.
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Ambliopía , Errores de Refracción , Retinopatía de la Prematuridad , Estrabismo , Baja Visión , Humanos , Recién Nacido , Niño , Preescolar , Lactante , Ambliopía/diagnóstico , Ambliopía/epidemiología , Prevalencia , Estudios Prospectivos , Etiopía/epidemiología , Errores de Refracción/complicaciones , Errores de Refracción/epidemiología , Estrabismo/epidemiología , Retinopatía de la Prematuridad/epidemiología , Retinopatía de la Prematuridad/diagnósticoRESUMEN
This cross-sectional study aims to investigate the prevalence and causes of visual impairment (VI) and blindness in Jiangsu Province, China in 2022 during the COVID-19 pandemic. Participants (n = 13,208, aged 18-93) underwent comprehensive ocular examinations. The prevalence and causes of binocular VI (presenting visual acuity [VA] ≥ 20/400 and < 20/63 in the better eye) and blindness (presenting VA < 20/400 in the better eye) were assessed according to the World Health Organization (WHO) criteria. The estimation of refractive error prevalence was conducted using the following classification: myopia ≤ - 0.50 diopters (D), high myopia ≤ - 6.00 D, hyperopia ≥ 0.50 D, and anisometropia ≥ 1.00 D. The overall prevalence of binocular VI and blindness was 21.04% (95% confidence interval [CI] 20.35-21.74%) and 0.47% (95% CI 0.37-0.60%). The highest prevalence of binocular VI was in the population aged 18-24 years old (46.29%, [95% CI 44.30-48.28%]), those with education at university and above (43.47%, [95% CI 41.93-45.02%]), students (54.96%, [95% CI 52.73-57.17%]). Uncorrected refractive error (URE) was the leading cause of presenting binocular VI (93.40%) and blindness (50.79%). The prevalence of myopia was 54.75% (95% CI 53.90-55.60%). Actions are needed to control URE and myopia within the adult Chinese population, with a particular emphasis on the younger, well-educated demographic.
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COVID-19 , Miopía , Errores de Refracción , Baja Visión , Personas con Daño Visual , Adulto , Humanos , Adolescente , Adulto Joven , Estudios Transversales , Prevalencia , Pandemias , COVID-19/complicaciones , COVID-19/epidemiología , Ceguera/epidemiología , Ceguera/etiología , Baja Visión/epidemiología , Errores de Refracción/complicaciones , Errores de Refracción/epidemiología , Miopía/complicaciones , China/epidemiologíaRESUMEN
PURPOSE: This study aimed to estimate the prevalence and main causes of blindness and visual impairment in population aged 50 years and older in Armenia using Rapid Assessment of Avoidable Blindness (RAAB) methodology. METHODS: The study team randomly selected 50 clusters (each consisting of 50 people) from all 11 regions of Armenia. Data on participants' demographics, presenting visual acuity, pinhole visual acuity, principal cause of presenting visual acuity, spectacle coverage, uncorrected refractive error (URE), and presbyopia were collected using the RAAB survey form. Four teams of trained eye care professionals completed data collection in 2019. RESULTS: Overall, 2,258 people of 50 years and older participated in the study. The age- and gender- adjusted prevalence of bilateral blindness, severe and moderate visual impairment were 1.5% (95% CI: 1.0-2.1), 1.6% (95% CI: 1.0-2.2) and 6.6% (95% CI: 5.5-7.7), respectively.The main causes of blindness were cataract (43.9%) and glaucoma (17.1%). About 54.6% and 35.3% of participants had URE and uncorrected presbyopia, respectively. The prevalence of bilateral blindness and functional low vision increased with age and was the highest in participants 80 years and older. CONCLUSION: The rate of bilateral blindness was comparable with findings from countries that share similar background and confirmed that untreated cataract was the main cause of blindness. Given that cataract blindness is avoidable, strategies should be developed aiming to further increase the volume and quality of cataract care in Armenia.
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Catarata , Presbiopía , Errores de Refracción , Anciano , Humanos , Persona de Mediana Edad , Armenia/epidemiología , Ceguera/epidemiología , Ceguera/etiología , Ceguera/prevención & control , Catarata/complicaciones , Catarata/epidemiología , Presbiopía/complicaciones , Prevalencia , Errores de Refracción/complicaciones , Errores de Refracción/epidemiología , Encuestas y Cuestionarios , Trastornos de la Visión/complicaciones , Masculino , FemeninoRESUMEN
PURPOSE: To investigate the association of subjects with refractive error and diabetic retinopathy (DR) in the United States comparing results between different race groups. METHODS: All data were derived from National Health and Nutrition Examination Survey (NHANES) from 2005 to 2008. The data were divided into four groups (emmetropia, mild myopia, high myopia, hypertropia) according to the spherical equivalent (SE), and those who met the enrollment conditions were selected as the study subjects. Multivariable logistic regression analysis was used to evaluate the relationship between refractive error and diabetic retinopathy risk. RESULTS: A total of 1317 participants were included in the study, including 331 participants with diabetic retinopathy, and 986 without diabetic retinopathy. After adjustment for potential confounders, subjects with high myopia were associated with a lower risk of diabetic retinopathy. The odds ratio (OR) was 0.44, 95% confidence interval (CI): (0.20-0.96), P-value = 0.040 in the multivariate regression analysis. Subgroup analyses showed that subjects with high myopia in the non-Hispanic Black group were associated with decreased odds of diabetic retinopathy. (OR was 0.20, and 95% CI: 0.04-0.95, P-value = 0.042). CONCLUSION: The results show that high myopia is associated with diabetic retinopathy in diabetic patients.
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Diabetes Mellitus , Retinopatía Diabética , Miopía , Errores de Refracción , Humanos , Estados Unidos/epidemiología , Retinopatía Diabética/complicaciones , Encuestas Nutricionales , Miopía/complicaciones , Miopía/epidemiología , Errores de Refracción/complicaciones , Refracción Ocular , Factores de RiesgoRESUMEN
Objective: To systematically compare and rank the accuracy of AI-based intraocular lens (IOL) power calculation formulas and traditional IOL formulas in highly myopic eyes. Methods: We screened PubMed, Web of Science, Embase, and Cochrane Library databases for studies published from inception to April 2023. The following outcome data were collected: mean absolute error (MAE), percentage of eyes with a refractive prediction error (PE) within ±0.25, ±0.50, and ±1.00 diopters (D), and median absolute error (MedAE). The network meta-analysis was conducted by R 4.3.0 and STATA 17.0. Results: Twelve studies involving 2,430 adult myopic eyes (with axial lengths >26.0 mm) that underwent uncomplicated cataract surgery with mono-focal IOL implantation were included. The network meta-analysis of 21 formulas showed that the top three AI-based formulas, as per the surface under the cumulative ranking curve (SUCRA) values, were XGBoost, Hill-RBF, and Kane. The three formulas had the lowest MedAE and were more accurate than traditional vergence formulas, such as SRK/T, Holladay 1, Holladay 2, Haigis, and Hoffer Q regarding MAE, percentage of eyes with PE within ±0.25, ±0.50, and ±1.00 D. Conclusions: The top AI-based formulas for calculating IOL power in highly myopic eyes were XGBoost, Hill-RBF, and Kane. They were significantly more accurate than traditional vergence formulas and ranked better than formulas with Wang-Koch AL modifications or newer generations of formulas such as Barrett and Olsen. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022335969.
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Lentes Intraoculares , Miopía , Errores de Refracción , Adulto , Humanos , Refracción Ocular , Inteligencia Artificial , Metaanálisis en Red , Estudios Retrospectivos , Errores de Refracción/complicacionesRESUMEN
Purpose: To describe the presence of ocular abnormalities in children with developmental delay (DD) and compare with normal children; to analyze associated risk factors, systemic problems, and the possible treatment that can be delivered. Methods: This was a cross sectional, observational study. We included children between one and 18 years, diagnosed as developmental delay in DD group, and next immediate age- and sex-matched children without developmental delay on the same day or during the same period in the control group. Detailed history and neuroimaging findings were noted. Uncorrected visual acuity, best-corrected visual acuity for distance and near, cycloplegic refraction, anterior, and posterior segment examination was carried out. Various ocular problems, delayed visual maturation (DVM), and cortical visual impairment (CVI) were diagnosed based on examination. Data were analyzed statistically, and P value <0.05 was considered as statistically significant. Results: Ninety-four children were included in each group. Mean age was 4.97 ± 3.84 years, and 64.89% were males. In DD group: Most common abnormal neuroimaging finding was gliotic changes; systemic associations: 39 children; 83 children had ocular problems: refractive error-70, strabismus-39, cataract-five, amblyopia-16; DVM-13; CVI-13 children; glasses and vision stimulation were advised in 39 and 65 children, respectively; whereas, in control group: refractive error-36, strabismus-15, cataract-two; amblyopia-20 children. Conclusion: 88.29% of developmental delay children had ocular abnormalities, commonest was refractive error (74.47%); these values were higher than in control group; common risk factors were low birthweight and consanguineous marriage; epilepsy was the most common systemic association.
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Ambliopía , Catarata , Errores de Refracción , Estrabismo , Masculino , Humanos , Niño , Lactante , Preescolar , Femenino , Ambliopía/diagnóstico , Ambliopía/epidemiología , Ambliopía/etiología , Estudios Transversales , Prevalencia , Errores de Refracción/complicaciones , Errores de Refracción/diagnóstico , Errores de Refracción/epidemiología , Trastornos de la Visión/diagnóstico , Trastornos de la Visión/etiología , Estrabismo/diagnóstico , Estrabismo/epidemiología , Estrabismo/etiología , Catarata/complicaciones , Refracción OcularRESUMEN
Down syndrome, also known as Trisomy 21, is a genetic disorder associated with mild-to-moderate intellectual disability, delays in growth, and characteristic facial features. A wide range of ocular complications are seen in children with Down syndrome, including strabismus, nystagmus, refractive errors, congenital cataracts, the presence of keratoconus, and decreased visual acuity. Early ophthalmic examination is needed for early diagnosis and treatment in patients. This narrative review examines ocular manifestations in children with Down syndrome and the importance of prompt ophthalmic interventions for treatment.
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Síndrome de Down , Discapacidad Intelectual , Nistagmo Patológico , Errores de Refracción , Estrabismo , Niño , Humanos , Síndrome de Down/complicaciones , Errores de Refracción/complicaciones , Estrabismo/complicaciones , Estrabismo/diagnóstico , Nistagmo Patológico/complicaciones , Nistagmo Patológico/diagnóstico , Nistagmo Patológico/genética , Discapacidad Intelectual/complicacionesRESUMEN
BACKGROUND: To evaluate factors associated with better outcomes from optical treatment alone in amblyopic children from 3 up to 7 years. METHODS: Data extracted from two studies with similar protocols, Amblyopic Treatment Studies 5 (n = 152) and 13 (n = 128) from the Pediatric Eye Disease Investigator Group database, were used to determine by regression analysis the factors associated with improvements in visual acuity in the amblyopic eye, inter-ocular visual acuity difference and stereoacuity. Input variables were aetiology of amblyopia (anisometropic, strabismic and combined-mechanism amblyopia), treatment compliance, visual acuity, interocular visual acuity difference, stereoacuity, tropia size at distance and near, age and refractive error at baseline. RESULTS: Despite the range of clinical factors considered, our models explain only a modest proportion of the variance in optical treatment outcomes. The better predictors of the degree of optical treatment success in amblyopic children are visual acuity of the amblyopic eye, interocular visual acuity difference, stereoacuity, treatment compliance and the amblyopic eye spherical-equivalent refractive error. While the aetiology of the amblyopia does not exert a major influence upon treatment outcome, combined-mechanism amblyopes experience the smallest improvement in visual acuity, tropia and stereoacuity and may need longer optical treatment periods. CONCLUSIONS: While results identify the factors influencing optical treatment outcome in amblyopic children, clinicians will be unable to predict accurately the benefits of optical treatment in individual patients. Whether this is because relevant clinical or non-clinical factors (e.g. nature and volume of daily activities undertaken) influences the outcomes from optical treatment has not yet been identified and remains to be discovered.
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Ambliopía , Errores de Refracción , Niño , Humanos , Ambliopía/terapia , Ambliopía/complicaciones , Agudeza Visual , Errores de Refracción/complicaciones , Resultado del Tratamiento , AnteojosRESUMEN
PURPOSE: The purpose of this study was to investigate the prevalence of cataracts, refractive disorders, age-related macular disease (AMD), and glaucoma, as well as their trends from 1990 to 2019 in Iran, in comparison with high-middle socio-demographic index (HMSDI) countries and the world, using the Global Burden of Disease (GBD) 2019 study. METHODS: The GBD study provided data on the prevalence of blindness and visual impairment (VI), as well as four of their causes including cataracts, refractive disorders, age-related macular disease (AMD), and glaucoma. Using Joinpoint analysis, the annual percent change (APC) was calculated to assess the trend of change in prevalence in each category of diseases from 1990 to 2019, stratified by sex and age, for Iran, HMSDI countries, and the world. RESULTS: In 2019, refractive errors and cataracts were the most common causes of blindness and VI for both genders in Iran, HMSDI countries and the world. Iran had a higher age-standardized prevalence in all four categories of ophthalmologic disorders compared to HMSDI countries and the world for both genders in 2019. Additionally, the age-specific prevalence of all four disorders in 2019 was higher in Iran compared to HMSDI countries. However, in terms of trends of prevalence from 1990 to 2019, the rate of reduction for the four ophthalmologic disorders in Iran was higher than in HMSDI and the world for both males and females. Furthermore, Iran had a greater percentage of reduction in prevalence for all age groups in all four disorders compared to HMSDI countries. CONCLUSION: The prevalence of cataracts, refractive errors, AMD, and glaucoma in Iran was higher compared to HMSDI countries in 2019 for both sexes and all age groups, but the trends of prevalence for all four disorders from 1990 to 2019 in Iran had a higher slope of reduction compared to HMSDI countries for all ages and sexes.
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Catarata , Glaucoma , Degeneración Macular , Errores de Refracción , Baja Visión , Humanos , Masculino , Femenino , Carga Global de Enfermedades , Irán/epidemiología , Prevalencia , Ceguera/epidemiología , Ceguera/etiología , Baja Visión/epidemiología , Baja Visión/etiología , Errores de Refracción/complicaciones , Errores de Refracción/epidemiología , Glaucoma/complicaciones , Glaucoma/epidemiología , Catarata/complicaciones , Catarata/epidemiología , Degeneración Macular/complicacionesRESUMEN
Background: Childhood visual impairment has a significant effect on social life, educational performance, and professional choices, and can lead to poverty. Aims: To review the prevalence and causes of visual impairment among children aged 5-17 years in the Eastern Mediterranean Region (EMR). Methods: This study was conducted in 2021 using the Preferred Reporting Items for Systematic reviews and Meta- Analyses (PRISMA) method. We searched Google Scholar, PubMed, Web of Science, Scopus, Index Medicus for the Eastern Mediterranean Region, and Medline for studies published between January 2000 and April 2020. The articles included were epidemiological studies of prevalence and causes of childhood visual impairment published in peer-reviewed journals. Results: Of the 12 705 articles screened, 23 from 9 countries met the inclusion criteria. The pooled prevalence of uncorrected, presenting, and best-corrected childhood visual impairment was 11.57%, 8.34% and 1.21%, respectively. The most common causes of childhood visual impairment were refractive error (51.89%), amblyopia (11.15%), retinal disorders (3.90%), corneal opacity (3.0%), and cataract (1.88%). There was a highly significant heterogeneity between the studies (P < 0.0001). Conclusion: The prevalence of visual impairment among children in the EMR was high, and the leading causes were uncorrected refractive error and amblyopia, which were avoidable. Access to eyecare services may help improve early diagnosis and treatment of preventable causes of childhood visual impairment.
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Ambliopía , Catarata , Errores de Refracción , Baja Visión , Niño , Humanos , Ambliopía/complicaciones , Baja Visión/epidemiología , Errores de Refracción/complicaciones , Catarata/complicaciones , Prevalencia , Región Mediterránea/epidemiologíaRESUMEN
Approximately 7% of children in the United States younger than 18 years have a diagnosed eye disorder, and 1 in 4 children between two and 17 years of age wears glasses. Routine eye examinations during childhood can identify abnormalities necessitating referral to ophthalmology, which optimizes children's vision through the early diagnosis and treatment of abnormalities. The U.S. Preventive Services Task Force recommends vision screening at least once in children three to five years of age to detect amblyopia or its risk factors to improve visual acuity. The American Academy of Family Physicians supports this recommendation. The American Academy of Pediatrics recommends screening starting at three years of age and at regular intervals in childhood, and that instrument-based screening (e.g., photoscreening, autorefraction) is an alternative to vision charts for testing visual acuity in patients three to five years of age. Eye examinations include visual acuity testing, external examinations, assessing ocular alignment and pupillary response, and assessing for opacities with the red reflex examination. Common abnormalities include refractive errors, amblyopia (reduction in visual acuity in one eye not attributable to structural abnormality), and strabismus (misalignment of the eye). Rare diagnoses include retinoblastoma (often detectable through loss of red reflex), cataracts (detectable by an abnormal red reflex), and glaucoma (often manifests as light sensitivity with corneal cloudiness and enlargement).
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Ambliopía , Errores de Refracción , Estrabismo , Selección Visual , Niño , Humanos , Ambliopía/etiología , Selección Visual/efectos adversos , Estrabismo/diagnóstico , Estrabismo/complicaciones , Estrabismo/terapia , Errores de Refracción/diagnóstico , Errores de Refracción/complicaciones , Errores de Refracción/terapia , Atención Primaria de SaludRESUMEN
Purpose: To document the spectrum and magnitude of eye disorders and visual impairment in the Dongaria-a Particularly Vulnerable Tribal Group in the Rayagada district of Odisha, India. Methods: A door-to-door screening protocol included a record of basic health parameters, visual acuity for distance, and near and flashlight examination of the eyes. Spectacles were dispensed to those who improved; those who failed the screening were referred to fixed (primary and secondary) eye care centers. Results: We examined 89% (n = 9872/11,085) of people who consented for screening. The mean age was 25.5 ± 18.8 years; 55% (n = 5391) were female; 13.8% (n = 1361) were under-five children, and 39% (n = 3884) were 6 to 16 years. 86% (n = 8515) were illiterate. 12.4% (n = 1224) were visually impaired, of which 9.9% had early moderate VI, and 2.5% had severe VI and blindness. Uncorrected refractive error was detected in 7.5% (n = 744) and cataracts in 7.6% (n = 754); among the adults, 41.5% (n = 924/2227) had presbyopia. In children, 20% (n = 790) had vitamin A deficiency, 17% (n = 234) had global acute malnutrition, and 18% (n = 244) were stunted for their age. Almost two-thirds (62%, n = 6144) confirmed habitual intake of alcohol, and 4% (n = 389) of adults had essential hypertension. Following the screening, 43.5% (n = 837) of referred patients reported to the fixed centers, and 55% (134/243) of people advised underwent cataract surgery. Spectacles were dispensed to 1496 individuals. Conclusion: Visual impairment and malnutrition are high in Dongaria indigenous community. Permanent health facilities and advocacy would improve this community's health and health-seeking behavior.
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Catarata , Errores de Refracción , Baja Visión , Adulto , Niño , Humanos , Femenino , Adolescente , Adulto Joven , Masculino , Prevalencia , Baja Visión/diagnóstico , Baja Visión/epidemiología , Baja Visión/etiología , Ceguera/diagnóstico , Ceguera/epidemiología , Ceguera/etiología , Errores de Refracción/complicaciones , Errores de Refracción/diagnóstico , Errores de Refracción/epidemiología , Agudeza Visual , Catarata/complicacionesRESUMEN
PURPOSE: Controversy exists regarding the influence of peripheral visual experience on the onset and progression of childhood myopia. This longitudinal, observational study evaluated the relationship between relative peripheral refraction (RPR) and changes in refractive error and axial length (AL) over 12 months in White children aged 6-7 and 12-13 years with a range of baseline refractive errors. METHODS: Cycloplegic baseline autorefraction at horizontal retinal eccentricities of 0° and ±30° were recorded with the Shin-Nippon NVision-K 5001 while AL was measured using the Zeiss IOLMaster 700. Measurements were repeated after 12 months on a subgroup. Refractive data were transposed into power vectors as mean spherical equivalent (M), J0 and J45 . RPR was calculated by subtracting central from peripheral measurements. Participants were defined as myopic (M ≤ -0.50 D), premyopic (-0.50 D < M ≤ +0.75 D), emmetropic (+0.75 D < M < +2.00 D) or hyperopic (M ≥ +2.00 D). RESULTS: Data were collected from 222 and 245 participants aged 6-7 and 12-13 years, respectively. Myopic eyes demonstrated, on average, more hyperopic RPR. Emmetropes and premyopes displayed emmetropic RPR, and hyperopes showed a myopic RPR. Fifty-six 6- to 7-year-olds and seventy 12- to 13-year-olds contributed 12-month repeated measures. Longitudinal data demonstrated a significant relationship between a more hyperopic RPR in the nasal retina and greater short-term axial elongation in teens with myopia at baseline (ß = 0.69; p = 0.04). Each dioptre of relative peripheral hyperopia in the nasal retina was associated with an additional 0.10 mm (95% CI: 0.02-0.18 mm) annual increase in AL. CONCLUSIONS: Hyperopic RPR in the nasal retina of myopic children is indicative of increased risk for rapid axial elongation and may be a useful metric to support decision-making in myopia management.
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Hiperopía , Miopía , Errores de Refracción , Adolescente , Niño , Humanos , Miopía/etiología , Refracción Ocular , Errores de Refracción/complicaciones , Retina , Población Blanca , Estudios LongitudinalesRESUMEN
Purpose: To evaluate the outcomes of lensectomy with a glued intraocular lens (IOL) in spherophakic eyes with secondary glaucoma and assess factors associated with failure. Methods: We prospectively evaluated outcomes of lensectomy with glued IOL in 19 eyes with spherophakia and secondary glaucoma (intraocular pressure (IOP) ≥22 mm Hg and/or glaucomatous optic disc damage) between 2016 and 2018. The vision, refractive error, IOP, antiglaucoma medications (AGMs), optic disc changes, need for glaucoma surgery, and complications were assessed. Success was defined as complete when IOP was ≥5 and ≤21 mmHg without AGMs; qualified success as similar IOP with up to 3 AGM; the need for >3AGM/additional surgery for IOP control was considered a failure. Results: Preoperatively, the median (interquartile range: IQR) age was 18 (13.5-30) years. IOP was 16 (14-22.5) mmHg on a median of 3 (2,3) AGMs. Median postoperative follow up was 27.7 months (11.9, 39.7). Postsurgery, most patients achieved emmetropia, with significantly decreased refractive error from a median spherical equivalent of -12.5D to + 0.5D, P < 0.0002. The complete success probability was 47% (95% confidence intervals (CIs): 29-76%) at 3 months and was 21% (8 - 50%) at 1 year and 3 years. The qualified success probability was 93% (82-100%) at 1 year, which reduced to 79% (60-100%) in 3 years. None of the eyes had any retinal complications. The higher number of preoperative AGM was found to be a significant risk factor (p < 0.02) for the failure of complete success. Conclusion: One-third of the eyes had IOP control without the need for AGM postlensectomy with glued IOL. Surgery resulted in significant improvement in visual acuity. The higher number of preoperative AGM was associated with poor glaucoma control after glued IOL surgery.
Asunto(s)
Glaucoma , Cristalino , Lentes Intraoculares , Errores de Refracción , Humanos , Adolescente , Adulto Joven , Adulto , Adhesivos , Glaucoma/cirugía , Glaucoma/etiología , Cristalino/cirugía , Lentes Intraoculares/efectos adversos , Presión Intraocular , Errores de Refracción/complicaciones , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
PURPOSE: The present study was aimed to compare the epidemiological and ocular findings of twin children in comparison with non- twin age matched individuals as their control. METHODS: In this cross sectional study, a total of 90 twins (180 cases) were compared with 182 non- twin matched children. All the study participants were examined by a comprehensive ophthalmic examination including measurement of the best corrected visual acuity (BCVA), cycloplegic refraction, ocular deviation, strabismus as well as the anterior and posterior ophthalmic examinations. Demographic information of children were collected by using an organized questionnaire. Monozygotic twins were considered if there were similarity of their phenotypic characteristics and gender, otherwise the twins were considered as dizygotic. RESULTS: The mirror- image twins (MIT) was defined according to the laterality of symmetrical ocular characteristics of twins. In this study, the mean age of the study participants was 7.08±4.42 and 7.58±3.99 years in twins and non-twins groups, respectively (P=0.253). Among the twins, 27 (30%) were monozygotic. Refractive form of MIT was seen in 5 twins (2.8%). The spherical refractive error was more hyperopic in twins compared to non- twins (P=0.041). BCVA in the twin group (0.07±0.16LogMAR) was significantly worse than non-twins (0.03±0.08LogMAR, P < 0.001) and higher percentage of them were amblyopic (37.2% versus 10.4%, P=0.005). Twin and controls had strabismus in 17.2% and 1.6%, respectively (P < 0.001). Regarding the comparison between mono- and dizygotic twins, more significant percentage of monozygotic twins had amblyopia (P=0.004) and strabismus (P=0.047). Multivariate analysis showed significant correlation among low gestational age and female gender, low birth weight and seizure. CONCLUSION: Female sex, less gestational age, low birth weight, amblyopia and strabismus were significantly higher in twins. Therefore, it is important to check their refractive error, amblyopia and strabismus to prevent their further complications.
Asunto(s)
Ambliopía , Errores de Refracción , Estrabismo , Niño , Preescolar , Femenino , Humanos , Ambliopía/etiología , Estudios Transversales , Factores Epidemiológicos , Errores de Refracción/epidemiología , Errores de Refracción/complicaciones , Estrabismo/epidemiología , Gemelos Monocigóticos , Agudeza Visual , MasculinoRESUMEN
Purpose: Our study's goal was to investigate the individuals who took a pre-military examination and were pronounced "unfit for military service," in terms of etiological grouping, legal blindness, and whether or not the illness could have been prevented. Methods: The files of 174 individuals deemed "unfit for military service" due to eye disease at the State Hospital Ophthalmology Department between January 2018 and January 2022 were retrospectively evaluated. The disorders were classified as refractive error, strabismus, amblyopia-related, congenital, hereditary, infectious/inflammatory, degenerative, and trauma-related pathologies. The reasons for unsuitability for military service were classified according to monocular and binocular legal blindness, preventability, and treatability with early diagnosis. Results: In our study, the reasons associated with refractive error, strabismus, and amblyopia were placed first in the etiology of unsuitability for military service (40.2%). The next most prevalent condition was trauma (19.5%), which was followed by degenerative (18.4%), congenital (10.9%), hereditary (6.9%), and infectious/inflammatory disorders (4.0%). There was a history of penetrating trauma in 79.4% of trauma patients and blunt trauma in 20.6% of patients. When the etiology was evaluated, 19.5% were in preventable and 51.2% were in treatable group with early diagnosis. In our study, legal blindness was detected in 116 patients. Of these patients, 79% had monocular legal blindness and 21% had binocular legal blindness. Conclusion: It is vital to investigate the etiology of visual disorders, control preventable causes, and determine the methods that will provide early diagnosis and treatment of curable causes.
Asunto(s)
Ambliopía , Personal Militar , Errores de Refracción , Estrabismo , Humanos , Estudios Transversales , Estudios Retrospectivos , Ceguera/etiología , Trastornos de la Visión/etiología , Estrabismo/complicaciones , Errores de Refracción/complicacionesRESUMEN
PRCIS: Primary congenital glaucoma (PCG) in Tunisian children seems to be characterized by a high prevalence of inherited and advanced forms of the disease. Primary combined trabeculotomy trabeculectomy (CTT) allowed satisfactory long-term intraocular pressure (IOP) control and reasonable visual outcome. PURPOSE: To report the long-term outcome of CTT as the initial glaucoma surgery in children with PCG. METHODS: Retrospective analysis of children who underwent primary CTT for PCG between January 2010 and December 2019. The main outcome measures were IOP reduction, corneal clarity, complications, refractive errors, and visual acuity (VA). Success was defined as IOP <16 mm Hg without (complete) or with (qualified) antiglaucoma medication. The WHO criteria of vision loss were used to categorize visual impairment (VI). RESULTS: Of 62 patients, 98 eyes were enrolled. At the last follow-up, the mean IOP was reduced from 22.7 ± 4.0 mm Hg to 9.7 ± 3.9 mm Hg ( P < 0.0001). The complete success rate was 91.6%, 88.4%, 84.7%, 71.6%, 59.7%, and 54.3%, at the first, second, fourth, sixth, eighth, and tenth year, respectively. Follow-up averaged 42.1 ± 28.4 months. Preoperatively, 72 eyes (73.5%) had significant corneal edema versus 11 eyes (11.2%) at the end of the follow-up ( P < 0.0001). Endophthalmitis was encountered in one eye. Myopia was the most common refractive error (80.6%). Data on Snellen VA were available for 53.2% of the patients; 33.3% achieved a VA ≥6/12, 21.2% had mild VI, 9.1% had moderate VI, 21.2% had severe VI, and 15.2% were blind. The failure rate was statistically correlated to the early disease onset (<3 mo) and to preoperative corneal edema ( P = 0.022 and P = 0.037, respectively). CONCLUSION: Primary CTT seems to be a good procedure in a population with advanced PCG at presentation, problematic follow-up visits, and limited resources.